Individual
DR. SCOTT G CROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 535-4130
(208) 535-4125
Mailing address
2860 CHANNING WAY, SUITE 115B, IDAHO FALLS, ID 83404-7531
(208) 535-4103
(208) 535-4125
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
M-7984
ID
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
M7984
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58057
BLUE CROSS
ID
05
—
805777500
—
ID
Enumeration date
12/30/2005
Last updated
06/29/2010
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